Speaker A
What first sparked your interest in pranayama, or when did you start using breath as a clinical tool?
Explore how pranayama breathing techniques can aid metabolism, disease reversal, and stress management with Dr. Nitin Patankar on Doc Tales.
Key Takeaways
- Breath is a powerful, evidence-based therapeutic tool for chronic disease management.
- Measuring and observing respiratory rate should be standard clinical practice.
- Integrating pranayama with modern medicine can enhance treatment outcomes and reduce medication dependency.
- Simple, mindful breathing exercises can be easily incorporated into daily routines for health benefits.
- Proper training in anatomy and physiology is essential for safe pranayama practice.
Summary
- Dr. Nitin Patankar shares his journey integrating pranayama as a clinical tool alongside modern medicine.
- A case of uncontrolled diabetes despite medication sparked his interest in breath-based therapies.
- Breathing patterns and respiratory rate are vital but often overlooked clinical markers.
- Pranayama can improve autonomic function, reduce stress, and aid in metabolic disease management.
- Simple breathing exercises can be taught quickly and have profound health benefits.
- Breathing abnormalities such as mouth breathing reduce nitric oxide intake and affect health negatively.
- Pranayama supports better sleep quality and can optimize medication use, even in serious diseases.
- The practice should be taught by those with knowledge of physiology and anatomy for safe and effective use.
- Breath control techniques like kumbhak and mudra therapy have scientific and traditional bases.
- Healing through breath involves understanding the body-mind connection and frequency science.
Chapters
- 00:00Introduction and Clinical Spark for Pranayama
- 02:34Host Introduction and Breath as a Therapeutic Tool
- 05:43Stress, Autonomic Function, and Breath
- 08:24Breathing Abnormalities and Clinical Observation
- 11:06Teaching Breathing in Medical Practice
- 15:28Breath and Autonomic Nervous System
- 18:30Breath Techniques and Disease Reversal
- 20:34Mudra Therapy and Breath Control
- 25:07Pranayama for Disease and Medication Optimization
- 26:56Best Practices and Healing Philosophy
Full Transcript — Download SRT & Markdown
Speaker A
One patient came who was following diet very strictly. He was following exercises, but HBA1C was stuck. Sugars were remaining high. BP was not coming under control. And patients and relatives were coming to me and saying, "We are doing everything, but it's not working. Why is it not?" I tried to increase the dose and sugar started going down. So, that was the spark.
Speaker A
Most people may not know that your heart rate is not constant. When we say vitals, there is a mention of respiratory rate, but nobody measures it. Because these are all nature's arts.
Speaker A
And what we are taught is basically nature's engineering. Sir, can you teach us a 30-second simple breathing exercise?
Speaker A
Simple thing. Keep left hand on the chest. If we teach all our patients to breathe abdominally and convert the active breathing exercise into a habit, then imagine what changes can occur. And that's how I've seen that then why patients' pancreas get cleared of fat cells. Why your liver gets cleared of fatty acids. And it is always a time when you start this.
Speaker A
Because if the things have become permanent, the genes which are opened up, they are now permanently open. There is no way to close them.
Speaker A
That's why reversal is possible, but with caveats. When you touch only the middle finger, nothing else.
Speaker A
And it always shifts toward the middle number. My intention should be there that I want to reverse my diabetes.
Speaker A
Omkar pranayama that you're talking about, sir, which diseases can we use it for?
Speaker A
Every. By doing these pranayams, your sleep becomes extremely good.
Speaker A
When is the best time to get maximum benefit from pranayam?
Speaker A
There is something called frequency science. Certain frequencies are healing frequencies, which we talk about all the chakras and all these things.
Speaker A
But taking minimum medicines is the best thing that pranayam has taught.
Speaker A
Welcome back to Doc Tales, a podcast for doctors, by doctors.
Speaker A
An initiative by Aristo Pharmaceuticals. I'm your host, Dr. Sushma Sangvi, a metabolic physician. As doctors, we have spent years studying medicine, the pathophysiology, the biochemistry, the pharmacology, and diseases.
Speaker A
But what if I told you that there's one very important therapeutic tool that is related to metabolism, stress, sleep, all associated with chronic disorders, is something that we all do over 20,000 times a day without thinking? Can you guess what it is?
Speaker A
Our breath. Yes, you heard it right, our breath. Can the way we breathe help us heal?
Speaker A
This is the question where we're going to find answers in today's Doc Tales episode. So for this, I welcome our guest, Dr. Nitin Patankar, sir, who has spent years exploring the fascinating intersection of medicine, metabolism, lifestyle disorders, and pranayam.
Speaker A
He believes that breathing is not merely a wellness practice. It is physiology, biochemistry, neurology, and medicine in action. So please welcome Dr. Nitin Patankar.
Speaker A
Welcome, sir, to Doc Tales. Thank you so much, and I'm very happy that you have called me to talk on this topic.
Speaker A
We all are very excited, sir. Dr. Nitin Patankar, as a physician trained in modern medicine, what first sparked your interest in pranayama, or when did you start using breath as a clinical tool?
Speaker A
Great question. You would use spark. So, we say unless... So, I see what we got there.
Speaker A
One patient came who was following diet very strictly. He was following exercises. Medicines where I felt it was perfect.
Speaker A
But HBA1c was stuck. Sugars were remaining high. BP was not coming under control. And patients and relatives were coming to me and saying you... So, that was the spark. It was a frustration.
Speaker A
I tried to increase the dose and sugar started going down. I restarted the dose, the sugar started going up.
Speaker A
That is the time when I thought we are missing something. And then I remembered all the things when I was learning yoga.
Speaker A
They were teaching us about HRV, that is heart rate variability. So, most people may not know that your heart rate is not constant like we say 72 per minute. It keeps on varying minute to minute. So, the more the variation, it is better.
Speaker A
So, heart rate variability, then what is the rate at which the person is breathing?
Speaker A
Then what is the autonomic function? What is the stress levels? So, I started thinking and then I started inquiring and I found out his stress levels were high.
Speaker A
HRV is low and I checked his cortisol levels were high. Now, I thought of what prescription I can give.
Speaker A
So, I didn't have anything, but I knew yoga. So, I started implementing the pranayama techniques, basically slow breathing techniques, and everything settles down.
Speaker A
Unfortunate part, I knew both. I knew modern medicine, I knew yoga, but I never thought of connecting it and nobody in my medical school or in practice when we go to CME's and learn something from stalwarts, nobody tells us this. Everybody talks of evidence-based medicine, where is the proof? Proof is existent, but we were not taught to look at it and that's where I started looking at pranayama and yoga as a tool in medicine, as a medicine.
Speaker A
If all physicians start thinking like the way you're thinking, it is difficult to explain everyone what role pranayama has. So, say if you have a colleague who's rushing into his OPD for the next patient, you have 30 seconds, how would you pitch this to him?
Speaker A
When patients are admitted, I go for rounds and I teach pranayama.
Speaker A
So, one physician asked me, "What are you doing?" Then, he was talking on the phone, "What is the blood count? Give this much insulin." He generally stopped.
Speaker A
Then, he started, "Do you have any answer for this?" I said, "What I'm doing is the answer." From that moment onward, he started coming and sitting in my OPD and started learning yoga.
Speaker A
So, most of us monitor pulse, blood pressure, oxygen saturation, and blood sugar every day for our patients.
Speaker A
Do you think breathing patterns are an overlooked clinical marker? Absolutely. Because when we say vitals, there is a mention of respiratory, but nobody measures it.
Speaker A
And the respiratory rate will tell you something much more than what pulse rate can tell you or even BP can tell you because all these things are like downstream.
Speaker A
The respiration, like it will guide all those things to its right place or wrong place. So, you must mention that respiratory rate has to be measured.
Speaker A
You look at all the variables that are available. Do you find any gadget which measures respiratory rate which is a crux of it?
Speaker A
So, your life is breathing. Pulse is dependent on respiratory rate. So, you neglect it, you neglect your health.
Speaker A
True, sir. What are some breathing abnormalities doctors should learn to observe more carefully? Do you know how many times you are breathing now?
Speaker A
No, sir. So, anybody who is watching this podcast should find out how many times they are breathing. When I take lectures, I have a habit of asking questions. So, the students usually are sitting in a tense position. So, they are sitting like...
Speaker A
So, mouth open. So, you are breathing with mouth open, that time your nasal respiration is gone. Nitric oxide secretion from nose is gone. So, your major respiratory input is gone. So, all these things should be observed and this doesn't require any lab test. When a patient is sitting in front of you in your cabin, you observe his respiration.
Speaker A
And with practice, you will know whether it is breathing fast, slow, or tense. Now, when you started studying the signs behind breathing, what surprised you the most?
Speaker A
But I didn't know much. Because I knew physiology. So, in physiology they teach us a lot of things. And we were impressed. Oh, nature has created such fantastic machinery.
Speaker A
But, we failed to observe the pattern of breathing. Because these are all nature's arts.
Speaker A
And what we are taught is basically nature's engineering. So, I always feel when I started learning, I started l...
Speaker A
But, we failed to observe the pattern of breathing. Because these are all nature's arts.
Speaker A
And what we are taught is basically nature's engineering. So, I always feel when I started learning, I started looking at whether it is any system, look at the art nature has created rather than the engineering marvels it has created.
Speaker A
So, sir, the students, the upcoming MBBS students, and the medical education which is there currently, do you think it gives enough attention to the physiology of breathing?
Speaker A
Yes, they give a lot of attention to physiology of breathing, biochemistry of breathing, but not the art of breathing. But, I always feel that yoga is not a alternative medicine.
Speaker A
Yoga should be part of our curriculum. Like we have exercise physiology is part, nutrition science is a part of it.
Speaker A
Similarly, yoga should be a part of our medical curriculum, and in which they should be teaching us about the art of observation.
Speaker A
And in our medical practice they teach us now inspection palpation percussion, auscultation. That inspection should be linked to all these physiological changes rather than looking at pathology.
Speaker A
So, according to you, the art of breathing is something that we need to teach our medical students.
Speaker A
Yeah, and 2,000 years back or 4,000, whatever timelines are there, these people have no machines.
Speaker A
So, they looked at it as art and developed a whole science behind it. Since we are sitting in a yoga studio, let's have a practical demonstration of the same.
Speaker A
Sir, can you teach us a 30-second simple breathing exercise which every doctor watching this podcast can do it with us.
Speaker A
100% but you should be the representative of all the doctors who are sitting there.
Speaker A
Okay, I'll try, sir. Simple thing. Keep left hand on the chest. Okay. Right hand on the abdomen.
Speaker A
Okay. And you have to breathe. Now what we are going to observe is how your hands are moving.
Speaker A
Okay, which hand is moving better, which hand is moving longer. So, let's begin. So, just close your eyes.
Speaker A
Don't try to change the rhythm of the breathing and breathe. Okay. I can cut short like medical trials.
Speaker A
They say give there is lot of benefits are seen the trial is cut short and it is applied.
Speaker A
Yes. I can observe so many things in this maybe 15 seconds. Wow. What you are doing is very shallow breathing.
Speaker A
So, breathing is not deeper. And secondly, within that shallow breathing also you are moving your chest more abdomen less. So, ideally the breathing should be abdominal breathing.
Speaker A
See, the God has created the big muscle diaphragm. And as they say there are two brains.
Speaker A
One is a gut brain and one is a real brain. So, what happens is over the years and brain getting lot of attention on thinking and what I'm going to do next and all those things so, the diaphragm is neglected and it
Speaker A
becomes so totally lazy LC. So, all chest muscles go up and show that up and come with that. So, that's why we don't breathe abdominally. If abdominal breathing is not there, the all those autonomic nervous system stimulation is
Speaker A
gone. So, now I will tell you that you do the same thing again but now consciously breathe a little deeper.
Speaker A
Breathe with abdomen. The chest will breathe automatically because if the diaphragm is pulled down, the chest will also go down. So, that movement should be there. So, breathe with abdomen. That's why in even music they tell, no?
Speaker A
So, that means your abdominal breathing should be involved in vocalization. So, close your eyes again.
Speaker A
Keep your hand on the chest, abdomen, and try to breathe abdominally. When you're breathing in, abdomen should go out.
Speaker A
Okay. How do you feel? Do you feel any difference? Yes, I feel much lighter. I feel very relaxed.
Speaker A
So, yes, there is a difference between how I was breathing earlier. And with this conscious abdominal breathing, I think I feel a little calmer, also.
Speaker A
Yeah, so that is the answer. That if we teach all our patients to breathe abdominally and converting the active breathing exercise into a habit, then imagine what changes can occur.
Speaker A
That is the beauty of breathing. So, we've been talking about breath as physiology. But, there's a distinction that goes much deeper.
Speaker A
Between breath as air movements inside and outside, and pranayama, or prana, as we call is something else entirely, isn't it?
Speaker A
You have asked a very deep question. When the nerve conduction is going on, when you are thinking, everywhere prana is involved.
Speaker A
So, breathing is a conveyance or the easiest way to understand prana. I I yoga schools everywhere. Every guru was telling that pran is different from breath.
Speaker A
But I never used to appreciate it. So, I was working in a transplant team.
Speaker A
See, suppose somebody's wanting a liver. And he's not getting a related donor. So, they wait for a cadaver donor. Now, cadaver is not dead body. So, you have to make a distinction between that. So, I had one patient who was for liver
Speaker A
transplant. And I was creating a donor. So, I was working desperately with him. Relatives were very anxious. And the last moment the donor canceled it. I don't want to donate. So, luckily that patient got a call from a hospital, our hospital, that
Speaker A
there is a cadaver there. There were around 2 and 1/2 days after which all consents were obtained.
Speaker A
Now, the patient were taken for transplant. The transplant team is ready. Everything is ready.
Speaker A
And what we call is cadaver was rolled into the OT. And suddenly there was a chaos in ICU.
Speaker A
So, I went there. As a physician, we don't get much chance to go to OTs. I went there. What happened?
Speaker A
They said that cadaver collapsed. I said, "What do you mean by cadaver collapse?" They said that there is a time come.
Speaker A
This is what the surgeon's words. A time comes when you are giving all electrolytes, all nutrition, ventilation, all electrical stimuli, everything is given.
Speaker A
But the cells stop responding. So, he mentioned something leaves the body. And now no more efforts can keep those cells alive.
Speaker A
So, something is gone. So, that is called a cadaver collapse. That organs are dead now, and they deteriorate very fast.
Speaker A
I realized at that time that what the surgeon mentioned that something left is what is prana.
Speaker A
But, there is a limit beyond which they don't survive. What leaves the body at that time, that is prana.
Speaker A
And those yogacharyas were also always mentioning that that breathing is a vehicle. But, what you are inhaling is prana.
Speaker A
What you can say fluid in thinking and imagining that when I'm breathing I'm not only taking in air, I'm also taking in prana. And once that connection is established you have got a goldmine.
Speaker A
So, that is prana. Thing that you just mentioned about the transplant, you know, something in this room has changed after hearing that story. And I myself feel it in my chest. It Is there a simple technique by which we can reset
Speaker A
our body and mind? So, do you have any such technique which you can teach us today?
Speaker A
Just follow the steps what I'm showing and you will reset yourself. So, resetting is basically exactly opposite of what regular pranayams that we do.
Speaker A
Basically, for adult people non-communicable diseases. So, we usually focus on extended exhalation. Here it is exactly opposite.
Speaker A
So, shorter forceful exhalation and longer inhalation. And if you observe for a normal breathing also without pranayam, without any normal person breathing, the inhalation is longer or inhalation is shorter and exhalation is longer. So, we are exactly reversing
Speaker A
that to reset it. So, now I will show you how to breathe that, okay? So, keep that rhythm in mind.
Speaker A
1 2 3 4 5 1 2 3 4 5 1 2 3 4 5. This is a rhythm and how you breathe is sit straight, tall, then hands on the knees and then you do inhalation and exhalation both little
Speaker A
forceful. So next person sitting to you can be able to hear you breathing. So it is something like this.
Speaker A
[snorts] So this is a breathing that literally resets you. But the secret of this is when you breathe this whether it is nine times, 18 times or 36 times after you finish breathing there is something called as a
Speaker A
physiological apnea. You don't need to breathe. Mhm. And that is a time when it is said that your subconscious mind is open.
Speaker A
Your mind is totally thoughtless. So anybody who is listening you can try that. If you start feeling giddy, light-headed, stop. But try to raise from nine to 18 to 27 to 36 and you will find your brain after say after you
Speaker A
finish that set is unable to think. So that can be easily practiced by doctors or anyone it is kind of office meetings anywhere.
Speaker A
I will definitely practice it, sir. So sir, metabolic syndrome, obesity, fatty liver, any lifestyle disorders, insulin resistance, we're talking about a metabolic syndrome. Now where does breathing fit into this picture?
Speaker A
You name the condition which is into the modern lifestyle disorders the center is autonomic nervous system.
Speaker A
Mhm. So and the only thing that you have a tool or a instrument to tackle this is breathing.
Speaker A
Mhm. So breathing sit exactly at the center of the wheel. And all these organs are involved around it.
Speaker A
So breathing has got that much importance and this is not what ancient people say.
Speaker A
This is what the RCTs, like people love to use that word. Yes. Randomized control trial, double blind trials, and evidence.
Speaker A
So, there is evidence, there are RCTs, and they say that unless you tackle autonomic nervous system, the treatment for all kinds of these diseases, like you say metabolic syndrome, now you say CKM syndrome, all these syndromes will remain incomplete
Speaker A
if you don't tackle autonomic nervous system. So, sir, other than these diseases mentioned in metabolic syndrome, do you think even PCOS, you know, which I think every third girl or woman has nowadays, uh polycystic ovarian syndrome that we
Speaker A
call, does breathing play an important part in that disease itself in or the syndrome?
Speaker A
Yeah, if you read the literature now, now they don't call it PCOD Yes. or PCOS. Now they call it PCOM.
Speaker A
Yes. So, they have now linked this condition of a pattern of polycystic ovaries linked to metabolism.
Speaker A
Okay. So, your answer is there. That it is metabolism, and when there is a metabolism, there is autonomic nervous system. When there is autonomic nervous system, there is breathing. When you want to tackle breathing, it is not breathing exercises, it is pranayama.
Speaker A
Mental health is affected and can be controlled with this. 100%. Simple chanting Gayatri mantra.
Speaker A
There are like swaras, which are like what is called as a high scale, low scale, mid scale.
Speaker A
And if you do that with exhalation prolonged, then you can change your mindset. Your perception keeps on changing.
Speaker A
I will show you how Gayatri mantra is chanted. When I make the hands like this, it is like in the midtones. When I say this, it goes up. When I say down, this goes down.
Speaker A
Mhm. And this is how the Gayatri mantra is chanted. So, first is Om Bhur Bhuva Svaha.
Speaker A
Tat Vitur Varenyam Bhargo Devasya Dhimahi Dhiyo Yo Nah Prachodayat Om So, you found the difference?
Speaker A
Yes. So, this is how you make the mantra and you chant it and you will get lot of benefits. So, yoga, breathing, pranayama, everything that is the science is developed around lay.
Speaker A
Mhm. Science is developed around the sounds. And I will explain you why chanting pranayamas are much better than silent pranayamas.
Speaker A
I see. Never thought about chanting Gayatri mantra in the way that you described, because usually when we are like how you said earlier, that's the way people chant. But it has so much significance and it's connected to your
Speaker A
breath. And that overall impacts your mental health and physical health, which is truly fascinating.
Speaker A
Yep. So, you speaking about this Gayatri mantra. So, how do these mantras connect with breathing and to your mind and body? Like how does these vibrations actually help us? Can you explain?
Speaker A
So, in yoga, they have described something called as the chakras. Yes. So, starting from Muladhara chakra, Svadhisthana chakra, so all those chakras till Sahasrara chakra. So, whole body is covered into that.
Speaker A
Now, these mantras, like Gayatri mantra, is a universal mantra. But for these chakras, they have got mantras and frequencies.
Speaker A
And they are like they are called as Bijakshari mantras. So, like we say "Om". Similarly, when you contract your lower abdomen or the suprapubic region and chant "Vam", it reaches there.
Speaker A
And what happens is, instead of like we saying "Om Gayatri mantra" and "Om", we say "Lam Gayatri mantra" and "Lam".
Speaker A
Mhm. For "Om", they have done a lot of research. So, when you start chanting "Om", it affects your brain.
Speaker A
So, every area has got a different thing. And, uh it may be like deviation, but if you know that somebody's Muladhara chakra is like not active or not strong enough, the person is always doubtful about everything that he does. And he has got
Speaker A
a lot of fat collected on the lower regions. Mhm. If person's like ability to look at the problems in different ways gone, where we chant "Yam Vam".
Speaker A
So, then he has got a lower abdominal obesity. Mhm. If person's courage is gone, so he may be brave, but he's not courageous. Courageous means you have to have lower resources and still do something. The upper abdomen is
Speaker A
affected. So, you looking at the person, you can find out which area is affected and which emotion is affected.
Speaker A
Mhm. So, then you can plan the mantras. So, that is the part of a therapy of pranayama.
Speaker A
I wouldn't think it is, you know, uh such deeper science is connected to the way we look or the fat distribution. We never think in that way as a physician. We just think about our medicines and investigations, but there
Speaker A
is much more to it as you explained. If I want to, you know, learn this, how long does one take to reach the sounds that you're talking about. It's not easy, like you said, you know, it has to
Speaker A
be right pronunciation. So, how does one practice this? See, in olden days you would have asked me this question, it would have been difficult because then you have to sit in front of the guru and learn everything.
Speaker A
Now, it because of the use of gadgets, it has become much easier. Now, if I tell you that there is a certain frequency has to be created while chanting, say lum.
Speaker A
Now, you won't know whether that frequency is created. But, now you just take two mobiles.
Speaker A
And on one mobile, you have got a sound frequency generator. So, you generate that frequency, keep it on your ears, and you know the like a framework. Yeah, I want to create that sound. But, we are not trained in
Speaker A
sound creation. So, you take a second mobile, and where there is a frequency analyzer.
Speaker A
So, if there's a frequency analyzer, you want to create a sound, say a 136 hertz.
Speaker A
Then, I start chanting, and the visual impact is best. So, I start chanting lum lum lum, and I'm not I'm hearing that lum, so I'm trying to match that. And the visual tells me whether it is it's not
Speaker A
136, it is going to 190. So, you try to be little lum lum. It is too low. You try to adjust that. So, the learning has become very easy with the gadgets. And yoga never said or those rishis never
Speaker A
told that never use gadgets. Mhm. So, so as they never said that you treat diabetes.
Speaker A
So, we know that diabetes is part of the spectrum, so you can treat. Similarly, you can use gadgets and learn much quicker.
Speaker A
So, pranayama can be taught by your various wellness instructor or, you know, these yoga so-called certified yoga instructors. But according to you, why is it important that it should be taught by someone who understands physiology and anatomy rather than a wellness
Speaker A
instructor? Great. So, if you want to treat something, you must know what you're treating.
Speaker A
So, blind treatment like a compounder giving a drug or a chemist giving a drug and a doctor giving a drug makes a lot of difference.
Speaker A
Because if you want to treat fever, the chemist can give paracetamol. But the doctor will first examine whether it dengue or leptospirosis, malaria and then treat accordingly.
Speaker A
Similarly, if you are trying to change your anatomy, physiology, psychology, so you must know what is the problem, what is normal, what is abnormal, and then there are pranayama is not a like a dish. Like in a hotel onion, pyaj
Speaker A
jo aata hai vaisa dish nahi hai ye. So, you have to order it. It is almost like a French cuisine.
Speaker A
So, aap specifically bolo, vo a jayega. So, that's why anybody who understands, it may not be a doctor, but who understands anatomy, physiology, biochemistry and some part of medicine, ki what is normal and what is abnormal and how it can be
Speaker A
brought from abnormal to normal. If that understanding is there, that person can treat. Otherwise, it will cause complications. Because sometimes it will work, but sometimes it will cause disaster.
Speaker A
That's why you need someone who understand this and then teach. So, sir, say the doctor is watching today. If they want to prescribe this for the various metabolic diseases that we're talking about, blood pressure, diabetes obesity what would be the format as to what How
Speaker A
many times should one do pranayama? Or are there any contraindications? So, how can we get to that so that it's easier for doctors watching this to prescribe to their patients?
Speaker A
Yeah. So, except from pediatricians, most of the physicians, diabetologists, endocrinologists cardiologists neurologists, they are treating the patients See, more than 70% of the patients who have disorders and who has got these problems.
Speaker A
So, first of all, you know, must know the contraindications. So, if there is a glaucoma, you don't do anything that is related to fast breathing.
Speaker A
Patient has got cardiac disease. Patient has got any metabolic disorder. We don't want any sympathetic system stimulation.
Speaker A
So, all those very, very popular pranayams, kapalabhati. I know on TV so many people say mark kapalabhati or kapalabhati karobaki sabdur hojayega.
Speaker A
Yeah, bhastrika pranayama. And people come and tell me that I use thousand strokes of kapalabhati.
Speaker A
It is not a competition. It is not a Guinness Book World Record. Kapalabhati can cause a lot of problems. There are people admitted with wrong kapalabhati with slip disc.
Speaker A
Then breath retention can cause arrhythmias. So, see, anything that can cause good effects, if used wrongly, can cause bad effects also.
Speaker A
So, you must know that. So, for all non-communicable diseases or our modern life diseases, first thing is all fast-paced forceful pranayams are out.
Speaker A
Okay. And people who are interested into evidence, they can go and see there are ample evidence showing how these can cause harm to people.
Speaker A
So, you must first practice, build your physiology, build resilience, and then you may have these pranayams, but otherwise slow breathing, slow rate breathing, long exhalation pranayams are the only pranayams that are required.
Speaker A
So so say somebody has hypertension. So how many times should they do pranayam and what kind is suitable for that particular patient?
Speaker A
So basically like first of all you have to select which pranayam. Right. Okay. Now then you decide keep on first day he should learn the actions or physiology of the pranayam.
Speaker A
Then start with the lowest possible repetitions and lowest possible depth. And then every third day or a fourth day you should feel the comfort.
Speaker A
And then see how it is responding. Now what happens is if you start say pranayam and take example of hypertension. So in 2023 there is a big meta-analysis which has come which shows that the pranayam can reduce the blood pressure 7
Speaker A
mm of mercury by just pranayam. And 3 mm diastolic pressure, 7 mm systolic pressure.
Speaker A
So when you start doing that and when you are on the highest dose of antihypertensive medicines you have to reduce those medicines.
Speaker A
Otherwise patient will start feeling giddy and then he will blame that pranayam is causing problems.
Speaker A
So then the at what rate you are progressing then at what rate you should that kumbhak has got tremendous benefits.
Speaker A
Kumbhak means holding the breath. And it's called as antar kumbhak or bahir kumbhak. When you inhale the breath and hold or when you exhale the breath and hold.
Speaker A
And there are a lot of people on Instagram and those are influencers who talk about kumbhak therapy.
Speaker A
As if it is they have invented something. So that is very dangerous when you are doing it for heart patients.
Speaker A
So you have to start retention by 1 second. Okay. So, slowly built up the pranayama practice and then there is a limit at how much you should be doing it. See, this is not more than area.
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Mhm. If somebody imagine investing 3 hours in doing pranayama, he's not going to get benefit. Maybe he may get some bad effects. So, usually what we say is say 9 minutes to 10 minutes.
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Okay. Of morning and evening. That is a dose. That is a prescription of pranayama.
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And then you have to follow the biochemical parameters. It is not that when you are doing pranayama and you're feeling good, that means you have to neglect the blood that you measure blood pressure, you measure blood sugars. So,
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you have to react to that and then change the pranayama like you change the dose.
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Right. So, patient say you are giving metformin and patient starts getting diarrhea, you have to change metformin.
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If you're giving a sulfonylurea and the sugar start going down, you change that. So, similarly you have to change pranayama modality or dose.
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So, we're talking about diabetes and hypertension and all these metabolic disorders right now. We are hearing this word reversal, diabetes reversal.
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Do you think it's possible by using pranayama? Like you've been practicing this for years and years. So, what does your experience say?
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Great. So, the word reversal has to be seen in various aspects. Now, what medical science defines reversal as say for example diabetes.
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Without medicines or without insulin with moderate lifestyle changes maintaining sugars normal for 1 year.
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So, it is a very tricky and very clever definition of reversal. Malum nahi. actual reversal is like you are maintaining your sugars all the time.
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So, I don't feel that is routinely possible. Because when we get diabetes, when we get obesity, or when we get any metabolic disorders, it's not only metabolism that is changed. Who drives the metabolism? The genes.
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So, there is there is something called as the epigenetics. So, there are some genes which can promote this and they were hidden or they were closed, they have opened up.
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Now, once they are opened up, you are now like keeping the surface clean, but the genes are still there.
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So, that's why they say you take all the efforts 1 year, it is good. But, for me, if you can switch off the genes, which is possible, then the disease can be really reversed.
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And here you enter into a realm of psychology and pranayama and yoga and everything where intention of causing these changes in epigenetics with pranayama and with all other medical measures will cause real reversal.
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And that has been seen. Okay, now, why the intention is important? Because if you do pranayama, your conscious intention has to go into a subconscious level.
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And it is like a architect putting in a map. The architect puts in a map and then he doesn't bother that whether the plumber is taking pipes from where. He has shown that this is the end result I want and
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then the contractor gets everything done. We our body has got that power of intention.
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And intention going mind can cause all the changes and really cause switching off the genes. And then the real reversal is possible.
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But again, once the genes are opened up once, they can open up again with the situation. So, you have to practice pranayama, practice intention.
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And in Bhagavad Gita, there is a great shloka. I have written a book on Gita as Gita is my grandmother. She tells stories. So, I looked at Gita telling stories. So, in 18th adhyay, there is a saying or there is a shloka. Daivam
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chaiva atra panchamam. Daivam means luck. Now, when I was reading that and writing over it, I said how Bhagwan Krishna can say ki luck ke upar chhod do. If it is luck, then you don't have to do anything.
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Exactly. So, then I realized ki what Bhagwan has put luck as a fifth factor.
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So, then suddenly it struck me that he says that luck determines in which attempt you will succeed.
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Ah. So, if you are lucky, maybe your second attempt will be successful. If your luck is not in your favor, you keep on trying. Vividhano prathak cheshta. You will succeed in fifth attempt, 10th attempt. There the pranayama comes into picture.
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Mhm. When you do any kind of a pranayama, you know that you are working with prana.
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And when you practice the kriya of pranayama, when you stop it, your brain is totally focused into that.
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And then it goes something like slumber. Mhm. The conscious mind stops working. So, that is the time when your intention gets rooted into your subconscious.
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Mhm. So, that is the time when like 108 figure comes into picture. If you practice a pranayama 108 times and you keep the intention in mind, then when you stop it, there's nothing else but the intention.
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Mhm. Then it goes down, and then you don't have to know the biochemistry and pathology, physiology. Intention will work.
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That doesn't mean you're not going to work peripherally. But you work peripherally, do pranayama, and keep the intention, then the reversal is possible.
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And that's how I've seen that then why patients' pancreas get cleared of fat cells, why your liver gets cleared of fatty acids.
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And it is always a like time when you start this. Because if the things have become permanent, the genes which are opened up, they are now permanently open. There is no way to close them.
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So, I call it a dragonfly effect. The dragonfly is only one animal where the wings are closed. There's only one effort in life it makes where the wings open up. The shoulder, the bones are cracked, and then it flies, has got its
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lifespan. It never close It can never oppose. So, if that effect has occurred, then whatever with your intention or something, that is not magic.
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This is not going back in time. But we have got ample time to do that. So, if you are diabetic for, say, 5 years, 7 years, 10 years, you can do that.
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But if you come with a 45 years diabetes or 35 years diabetes, where all the organs are now damaged, all the genes are now permanently set, then it may not be. But with the modern medicines like a GLP-1,
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where they help in doing this, you add to it pranayama, and then you can see the wonders.
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Pranayama is not magic. If the genes are permanently opened up and they have got that dragonfly effect, they cannot close, then you may not get reversal, you may get control.
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But for control also, pranayama helpful. But you require a peripheral effects also. That's why reversal is possible but with caveats.
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So, what kind of pranayama does a patient with obesity be prescribed? So, first of all, simple breathing because obese patient starts breathing abdominally.
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That is the first step. Whatever pranayama is going to follow. Then there are pranayamas which are basically anulom vilom pranayama uh which appears very simple. Then there is a uh called as a brahmari pranayama.
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But I personally prefer a omkar pranayama. So, that is a combination of so many things and when I was learning about omkar, I started exploring various things because of my background in medicine.
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So, like normally saying om and people know that it is a uma. So, they say it is three steps, but there is a six-step or shatpadi omkar, saptapadi omkar. And when you are chanting omkar, there are different positions of your
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fingers and positions of your tongue. If they are held, it gives tremendous benefits in omkar pranayama and then that is the only pranayama that you have to follow.
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Sir, is it possible for you to show us the omkar pranayama? There are tongue positions. So, I will describe the tongue position.
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Then there are hand positions. So, I will describe the hand positions and then there is a sound.
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So, which you have to produce. So, I will describe the sound and then produce it. And once that is over, I will describe it in sequence in how it happens. So, if you hold these two fingers together, index finger and thumb
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together and rest of the fingers are away and you breathe, don't keep it tight. Keep it light.
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So, you do this uh enough pressure on these two fingers and breathe and you will find your upper lungs are breathing.
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Try it. Yes sir, I can feel that. Yeah, then the second stage is when you touch only the middle finger, nothing else.
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And it's always shift toward the middle lungs. How does that happen? Ah, so that is that is called as a mudra therapy. This is also developed by ancient people by observation. And then you last two fingers you touch
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together, leave other fingers out and breathe, your focus shifts to lower lungs. So when we teach kapalabhati to people, when we feel bhastrika, so we have to have that something called as a lower bhastrika, upper bhastrika, middle bhastrika or lower kapalabhati, middle
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kapalabhati. In Omkar, we have to have whole such positions. So the first position is touching your ring finger to thumb. And then you have to hold your hand like this.
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Then the tongue position is tongue tip of the tongue touching to the back of the teeth. That is two positions are set and then the sound you are going to produce is oh.
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So and then you take a deep breath and produce a sound of oh. So that is first position. So this is what happens. When I hold this tongue is kept at the back of my tongue and I produce
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oh. Then second stage is keeping your little finger with thumb. And then your edge of the tongue to be touching to the edge of the upper teeth.
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And this is a position and then you have to produce a sound called as "O".
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Ooh. Okay? Ooh. So, what I do is now hold this hold my tongue and then I produce take a deep breath.
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[chanting] This is a second phase. Third phase is put your thumb on the face of the ring finger and now the position of the tongue is very important. You roll the tongue down and what we call it the base of the
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tongue. That is the tip of the frenulum linguae. You produce that and uh like uh you take a selfie and make a pout.
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Similarly, your position in the first phase was ooh. Try to produce ooh when you are doing this and tongue on the lower part, automatically it converts to ooh.
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[singing] This is a third position. Fourth position is when you are holding your index finger under your thumb.
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Index finger under your thumb. Yes. So, this is a position and now you tip your tip of the tongue to the palate hard palate. And now here when you are producing ooh, add some friction in the throat. So,
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it's not only ooh, it's something like ooh and h is added to that. So, when I do this ooh [singing] Then what you do is hold your thumb against the middle finger.
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And now you put your tongue into the soft palate. And here that Om kar jo bindi hota hai na Mhm.
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that sanunasik sound is called it. That comes into picture. So, how it happens is I now twist my tongue back toward the soft palate and I produce this sound of O, but now it is added with some nasal twang. So, I do this.
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And the last stage, shatpadi Omkar, where I hold the left thumb with my right hand fingers.
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And then hold these fingers to my thumb. Now, you look at it, it looks like a conch.
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So, it's called as shankha mudra. And now here that makara is there. Mhm. So, where your ma should be resonating with the nose and cheeks and everything. So, here what you do is This completes the Omkar.
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It's called as the shatpadi Omkar. Now, if you measure the timings, you will find that you're breathing every time you're breathing in and breathing out. And because you're producing a sound, it is not only in the mind that you are counting numbers,
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your mind cannot go anywhere else. It is focuses on the sound. So, your mind is now pointed.
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And when you finish this, your mind goes blank. And that is called as the silence.
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That is where your intention should be there. So, your story should be ready. Because if I finish my Om and then And then I started thinking Sushma must be doing now. Kya kar rahi ho? Usko aata hai ki nahi? So then it is gone. My
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intention should be there that I want to reverse my diabetes. So when you are when you finish this, you are not thinking anything, you are not breathing anything. That is a window that opens up. And with the practice, if
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you practice this for say 9 minutes, then you will open up the window and your intentions will go into the subconscious mind. And then you will find within 6 weeks to 8 weeks you're finding changes in your body. And you
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need not know what is happening. So that is the beauty of pranayama. And this is called the Omkar pranayama.
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So be it any disease, diabetes, blood pressure, obesity, the intention has to be there.
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Intention has to be there. Adhishthanam is the most important thing. And this Omkar pranayama pranayama that you're talking about, sir, which diseases can we use it for?
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Every. Every disease. I'm not saying that this is a replacement for medicine. But see, optimizing medicine is everybody's job. And I can write down on bond paper that if you follow Omkar pranayama, you can optimize the medicines even for cancer.
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Oh, wow. I think that would be a breakthrough if we have RCTs as you said.
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This is not breakthrough. This has been proven. Do we have evidence for that, sir?
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Lot of evidence. There are a lot of RCTs out there. Now we're talking about these various diseases, but the one who prescribes, we physicians, what would be your suggestion to physicians, which kind of pranayama or how many minutes should they do because
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everybody's stressed out? Between they're running between OPDs, between hospitals, between patients, between surgeries. So how many minutes should one do and what kind will help for physicians especially or the medical students?
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Simple. Nine cycles of reset pranayama. And then nine minutes of Omkar pranayama. That's all.
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That's very simple thing. I think we all can achieve that. And you notice we are breathing when you are doing Omkar pranayama we are breathing three to four times a minute, maximum five times a minute. And that five or six per minute frequency is
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called as a natural resonating frequency of breathing, heart and baroreceptors. So, the sympathetic parasympathetic system is made free of all other inputs and it starts sending like instead of your like internet connection sending 9 Mbps it starts sending the signals 150 Mbps
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and it sends to all organs relax. So, the organ relaxation there is no threat.
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No cognitive overload, nothing. You can relax, you can heal yourself. So, that's what happens.
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So, this slow controlled breathing is actually what we achieve while doing these Yeah. pranayama and the number that we usually we are breathing I think more than You breathe usually 14 to 16 breaths and when you are when you are thinking and
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difficult times, difficult thinking it goes more than 16. Once it goes more than 16 your HRV is low.
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Then if your HRV is low then your cortisol levels are high. Cortisol levels are high then your stress levels are high. Then your glucose levels become higher. Your baroreceptor reflexes are gone. You are slightly on more hypertensive side. Your repair is
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low and most important thing all these things will lead to sleep fractionation. So, basically sleep is for rejuvenation, repair. If your sleep is not proper by doing these pranayama your sleep becomes extremely good. So, you sleep for four hours or five hours but it will
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repairing sleep or it's a restorative sleep. That doesn't happen. So, when is the best time to get maximum benefit for pranayama?
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When you get up early in the morning. So, usually what was taught to us uh when we were children that when you're getting up from bed, even before you touch the ground, we had to chant something.
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That Samudra Vasane Devi Parvatastana Mandalay Vishnu Patni Namastubhyam Padasparsham Kshamasva Me means and then certain things and then pranayama.
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So, that is the best time and then when you're retiring, that is the time when you do that, your sleep is improved when your day is improved.
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And in a daytime, you follow the reset pranayama. Yeah, because in our busy schedules, I mean if I can do it maybe early morning or at night. Either one works, right, sir?
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So, Either one works, both will work better. So, do you think that the medical students right now who are studying medicine, should they receive any formal training in pranayama?
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And what would be your advice to the doctors who have passed out? Absolutely. See, whether it is in curriculum or not, learning this will definitely help them in advancing their career and advancing their own health. There is something
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called the frequency science. So, certain frequencies are healing frequencies which we talk about all the chakras and all these things.
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So, what do you feel that when the there are astronauts in the lab in the sky or space, how they are treated?
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No idea. Look at the NASA websites. So, there there is no medicine available with them. They are treated with frequency medicine.
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Okay. So, frequency medicine and Frequency medicine means frequency as medicine. As medicine like you described earlier, using different frequencies for different purposes.
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Very true, sir. What is one lesson you wish every doctor learned earlier in their career?
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The doctor should learn to protect himself. Because I have experience in last 40 years, whoever comes to our clinic complain about his health.
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And he's mentally, physically he is disturbed. And you write a prescription for the disease, but you counsel him also. Unconscious consciously you counsel him.
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And he takes away a lot of energy from you. So, if a doctor is really involved in the patient, then you feel extremely weak at the end of say 15 patients, 20 patients.
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And slowly that tolls builds up. And that's why you will find the hypertension, diabetes obesity.
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So, one thing before you start your career, that you have something in existence that protects your energy.
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So, that is stress management, that is health management, everything. But there the yoga can come into picture. But unless they are introduced at the early stage, you are already burnt out by the age of 40. And then you just do the work
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like a mechanical machine or you are AI. That kind of introduction should be there when you start your career.
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So, it's basically resetting yourself like how you explained, resetting your body and mind in between patients. So, learning the right technique at the beginning of your career and practicing that to prevent the burnout.
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Yes. Wow. So, now we move to our interesting rapid fire round, sir. Okay. One thought, one instinctive answer.
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Okay? The first one, you ready, sir? Yes, sir. Okay. One breathing habit every doctor should practice daily.
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It should be Omkar Pranayam. Okay. One thing medical college never taught us about stress.
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That stress exist, stress can be treated, and stress is to be treated like a disease.
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So, now another question is better for metabolism, sleep or exercise? Of course, sleep. Because you have to sleep, but that sleep should be sleep, hygienic sleep, restorative [clears throat] sleep, it should be repairing sleep, non-breaking sleep, and where the parasympathetic
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system at its highest. The next answer I know, but I will still ask you one Pranayam every doctor should know.
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Omkar Pranayam. Most misunderstood concept in health today. That health is a combination of not parts of the body. And if they are healthy, then everybody will be healthy.
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It is a Sanskrit saying that understand the one thing which will make changes in everything. So, it's basically your whole body and mind, they are together.
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So, it's called the body-mind medicine. So, if you are healthy in all aspects, then you are healthy.
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One thing that most doctors neglect about their health. Their health? Oh, because they don't understand what is health.
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And that's why they feel that running kilometers and doing something and earning money and being externally healthy and good biochemical reports is health.
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So, they are missing the point. Coffee or conscious breathing before a busy OPD? First conscious breathing, then coffee.
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I agree. One disease where breath work deserves much more attention. Obesity and hypertension. Okay.
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And one myth about obesity you'd like to break? Huh. Obesity is a disease of willpower.
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So, just by giving them knowledge or counseling them or motivating them will change it.
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It is a absolute myth. A obese person eats less. Maybe just walking few steps does more work than somebody else walking for few meters. So, that is a big myth that it is obesity is his willpower problem.
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So, many people say eat less, walk more doesn't work for obesity, right? Absolutely. Calories or cortisol?
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Cortisol. One lifestyle habit that gives the highest return on investment. Breathing. One health parameter every doctor should track personally.
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Again, breathing. Because have you anytime No, sir. tracked your breathing? I have I was thinking you'll ask me that question. No, I haven't taken my breaths per minute. I have never counted them. I mean, I have never felt the need.
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That's what. One lesson pranayama has taught you as a physician. That first of all, everything is prana.
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And pranayama means control over prana can give rise to healing, but more importantly, optimization of medicines. Because uh we are living in the era where there are a lot of things we need medicines.
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Mhm. But taking minimum medicines is the best thing that pranayama has taught me. A doctor who practices pranayama is usually wiser.
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Complete this sentence. True healing begins when When you understand what is healing. And that happens when?
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That it happens when you are unhealthy. Thank you, sir, for the rapid-fire round that you answered uh so wittily. And so, now on behalf of Doc Tales, I would love like to give you this token.
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Oh, thank you so much. in this, sir, we have some things which will keep the doctor away.
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[music] Every patient carries with them the most important therapeutic tool, their breath. The question is not whether we breathe. The question is whether we breathe in a way that affects our health, [music] that helps us heal. So, thank you, Dr.
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Nitin Patankar, for joining us on Doc Tales Thank you. and sharing your insights on this very important topic.
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[music] Until next time, keep learning, keep healing, [music] and do not underestimate the power of your breath.
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Because the next breakthrough in health may not be a new medicine. It may be a forgotten breath.
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[music]
Topics:pranayamabreathing techniquesmetabolismdisease reversalstress managementheart rate variabilityrespiratory ratechronic diseasesyoga therapymedicine integration
